Individual
COURTNEY LEE BEAUREGARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
11 OHIO ST, BANGOR, ME 04401-4760
(508) 250-3733
Mailing address
11 OHIO ST, BANGOR, ME 04401-4760
(508) 250-3733
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PC010285
STATE LICENSE
PA
Enumeration date
09/18/2008
Last updated
12/13/2023
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